Active NPI
Angela Dulac Cook, CCMP, CRANIO THERAPY
- Massage Therapist
- Saranac Lake, NY
National Provider Identifier
1881230142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 028980-1
- Practice address
- 41 Saint Bernard St
Saranac Lake, NY 12983-1834 - Phone
- (518) 524-5472
- NPI assigned
- Nov 21, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 028980-1 | NY | Primary |
Addresses
Primary practice location
41 Saint Bernard St
Saranac Lake, NY 12983-1834
Mailing address
PO Box 466
Keene Valley, NY 12943-0466
Phone (518) 524-5472
Other practice location 1
1915 NYS Rt 73
Keene Valley, NY 12943
Phone (518) 524-5472
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 028980-1 | NY | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1574294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574294400000",
"number": "1881230142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 466",
"city": "KEENE VALLEY",
"state": "NY",
"postal_code": "129430466",
"telephone_number": "518-524-5472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "41 SAINT BERNARD ST",
"city": "SARANAC LAKE",
"state": "NY",
"postal_code": "129831834",
"telephone_number": "518-524-5472"
}
],
"practiceLocations": [
{
"address_1": "1915 NYS Rt 73",
"address_purpose": "LOCATION",
"city": "Keene Valley",
"state": "NY",
"postal_code": "12943",
"country_code": "US",
"telephone_number": "518-524-5472",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "COOK",
"first_name": "ANGELA",
"middle_name": "DULAC",
"name_prefix": "Mrs.",
"credential": "CCMP, CRANIO THERAPY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-11-21",
"last_updated": "2019-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NY",
"license": "028980-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saranac Lake, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.